United Way of Central New York e-Pledge: United We Do More!

PLEASE NOTE, THIS IS NOT THE APPLICATION.
This is a screening tool used to determine your organization's eligibility to apply for the RFP.

Multiple Programs: If your organization seeks funding for more than one program, each program must be listed separately on this Eligibility Screen form. In the formal application, a separate set of program questions must be completed for each separate program you are applying for, and each application will be reviewed independently.

Applicants must review the 2026-2027 Results Framework. On this screen select the Impact Goal each of your programs most aligns to. In the full application you will also select the specific Path within that area and show alignment with its required outcomes (# Served and % Better Off).

Within two business days of submitting this form your organization will receive an email with your eligibility determination and if applicable, a link and login credentials to access the application.

Notifications will be sent to the application contact person you list on this form.

If approved, the application contact will be able to request login information for other agency personnel who might need to access the application as well.

If you have any questions, please contact the impact team at rfp@unitedway-cny.org

*Agency Name
(Maxium # of characters is 40)

Agency Name Line 2

*Agency Address

Address Line 1

Address Line 2

City

State/Province

Zip/Postal Code

Country

EIN

*

Agency Description

*

Application Contact Name

Prefix

*First

Middle

*Last

Suffix

*Application Contact Phone

Area

Number

Ext.

*

Application Contact Email

Comments

Click the (+) to add each program.

* Application Contact Job Title

* Are you a 501(c)(3) nonprofit organization?

Yes

No

* Do you have a fiscal sponsor who is a 501(c)(3) nonprofit organization?

Yes

No

* Please enter the name of your fiscal sponsor here.

* How many years has your agency been in operation?

* Does your organization employ at least one full-time staff member (1.0 FTE or greater)?

Yes

No

* Does your agency commit to tracking and reporting required metrics (# served and % better off) throughout the grant term.

Yes

No

* If funded, does your agency agree to participate in monitoring, evaluation, and shared learning activities with United Way.

Yes

No

* Does your agency operate and deliver services within Onondaga County?

Yes

No

* Does/do the program/programs you are applying for address immediate/basic needs or systemic barriers including but not limited to housing, food, transportation, financial stability, health, or youth opportunity.

Yes

No

* Select your annual agency budget range.

$100,000-$250,000

Greater than $250,000

Will your organization or fiscal sponsor be able to provide the following requried documentation with your application:

* IRS Form 990/990EZ

Yes

No

* Most recent reviewed/compiled financial statements

Yes

No

* Current year operating budget

Yes

No

* IRS Form 990

Yes

No

* Most recent audited/reviewed financial statements

Yes

No

* Current year operating budget

Yes

No

*Please list all programs and their corresponding impact goal:

	Click the (+) to add a program and enter program name:	Please select the impact goal that aligns most closely with the program:

Items marked with an asterisk(*) are required